Drug interactions
Dronedarone + Mexiletine
Severity: Major
Dronedarone and Mexiletine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Dronedarone inhibits CYP2D6 and may increase mexiletine levels, and both drugs affect cardiac conduction. This could produce toxicity, QT prolongation and proarrhythmia.
What this interaction means in plain words
Dronedarone and Mexiletine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dronedarone belongs to Cardiovascular; Mexiletine belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by dronedarone plus additive electrophysiologic effects.
What to do
Avoid the combination where possible; if used, reduce the mexiletine dose and monitor ECG and for toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Mexiletine?
MediHelp rates the interaction as major. Dronedarone and Mexiletine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dronedarone inhibits CYP2D6 and may increase mexiletine levels, and both drugs affect cardiac conduction. This could produce toxicity, QT prolongation and proarrhythmia.
How serious is the interaction between Dronedarone and Mexiletine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, reduce the mexiletine dose and monitor ECG and for toxicity.
What other medicines interact with Mexiletine?
MediHelp also lists interactions of Mexiletine with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Mexiletine page.
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